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APPLICATIOtm. FOR CONSTRUCTI�1 PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION Jt�� BUILDING �MECHANICAL �PWMBING ❑ SIGN <br />OWNER MIILR��PESS dTY ZIP PMONE <br />�'�'.�4irH.�,� ti�wss�s�+e . �.�5e2.-'��-&.,h,.�.b.. Y3w�.f�... g.6o}iV "35V-2-43C <br />T NAhE i � MAILADORESS CITV 2i PHONE � <br />a9CNITECTOR0E51GNER MAILpODRE55 CITV ?ip PHONE <br />�65iGtv L.�.�ac F�� �153^ bS'� � <br />GENERALCONTRACTOR MA1lADORE55 CITv ZIP 5 8o3c� PNONE STATELIGENSE• <br />.��Yc�...._.....='b�}aw�.r.S..��czi�v�..-38'}z.},-�3•tr-- Bwtg..�.�+-r.{,.35�^�-v;S �'ifitiwl+.�3751- <br />MECHANICALCONTOACTOR AtA�LR��iiES� CITV ZIP PNONE STATEIIGENSE• <br />�„� s�T�,�„r�, $N o . '37jq-+s{I l � <br />PLUMBINGGONTHACTON I.IAILAOORESS Cltt 21P PMONE STATELICENSE� <br />�-C1- U-c�eiA,v�.. __ �--tC. S�erS 335 -a9�e.� <br />CONTRACT `FPICE OF WORN <br />� �J��DO� <br />]ESCRI WOBKANDSOURREFOOTRGE <br />' '. 1� i l�. .. � <br />USE <br />LEGAL DE'Sy♦CRIPTION OF PROPERTY �SNOWABELOI <br />LOT-/�- BLOCK OF <br />PqRCELTR%I.D.NUMBER <br />CONSTNUCTIONLOANLENDEF.ADDRESS.7ELEPNONENUMBER <br />L.�F �h N�n.� v v�' �'I't C.. <br />PROJL•CTADDR S <br />'�\'�� So.2� � <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITEM <br />'YATER CLOSET(TOILET) <br />BATHTUB <br />� VATORV (WASH BASINI <br />KITC N SINK 8 DIS /�j yh_,{�/� /�_ a� 1r <br />DISHWA ER �'�yr�£ �' ��C <br />LAUNDRY T Y ��1 <br />CLOTHESWAS 6[i /(J��'ilf� r,y� <br />URINAL L ( � �h— �'(�/ <br />DRINKING FOUNTP L..�y �� ��t� <br />FLOOR DRAIN ��' V �/1�1 <br />BACKFLOW PREVL.._.. ��� <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE i1SE ONLY: <br />FRONTSETBACK REARSEIBACK <br />USE IDNE I LOT AREp <br />�3 —Z <br />iNiAKEBV <br />IN]L•1� <br />FIRE SPRINNlERS REO'0 <br />onrE <br />S� <br />CCYTpLT PERSON �NO PHONE NO. <br />1= <br />i HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVC-RNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITIi WHETHER SFECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT � AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLIC�TION IS MADE AND I COMPLY WITH THE STATE <br />CONTRA TOqS LAW 18.27 RCW AND 296.200 WAC. <br />A/C—A/HNDLG UNITS—H,P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT NEATERS—B.T.U. M <br />GLOTHES DRYERS <br />VENTILF.TION FAN <br />RqNGEHOOD <br />PUMP <br />PIPING <br />WST FAN <br />M E.A. <br />016 <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE S <br />;yDi;'.,', 9;�1��1 <br />�i %, FE�S29, �3 P iiff'%/_ 3 <br />,�YES ❑ NO BUILDING <br />OLLUCAYLv XOqpNFLLiN0UNi15 <br />aauv / PLUMBING <br />BnSEMENT MECNANICAL <br />YES � NO <br />ADDITIONAL PLAN CHECK <br />OTHER <br />Sl'ATE BUILDING SURCHARGE <br />� <br />� � <br />veo ev CITY OF EVERETT PUBUC WORKS <br />IOCAL SALES <br />7/c�. TAX CODE IS 3105 rorn� _ � � ��-' <br />� =ti :L�• - 1���;r. Ch � r:.. -f' �,l..a ofi��J�:.� o�� /= /J�vtiC��, <br />